Type 2 diabetes (T2D) frequently presents with cardiovascular complications already established, with cardiovascular diseases (CVD) accounting for 40–80% of deaths in patients with T2D. Once atherosclerotic cardiovascular disease (ASCVD) is diagnosed in T2D, glucose-lowering alone remains necessary but insufficient. HbA1c remains central for assessment of glycemic control, whereas cardiovascular risk is determined by established ASCVD, heart failure, chronic kidney disease, blood pressure, lipid parameters and other parameters. Therapeutic decisions should therefore incorporate parameters beyond only glycemic control [1,2,3] We review the potential role and scope of Dapagliflozin and Sitagliptin in this setting. ✔ Dapagliflozin sitagliptin combination offers complementary cardiometabolic benefits, extending beyond HbA1c reduction, integrating plaque stabilisation, anti-inflammatory effects, weight and BP reduction, and improved functional recovery, thereby supporting a CV-first therapeutic approach in T2D patients with ASCVD.